Implications of New Age Adjustment Standard 

on Racial/Ethnic Health Disparities 

By Olivia Carter-Pokras, PhD


Closing the Gap, Hispanic Agenda for Action • October 1998


As of September 1, 1998, HHS agencies and programs that use 

age-adjusted* death rates must change the population standard they use from the year 1940 base to the year 2000 

projections from the Bureau of the Census. This new standard, which 

will be applied to adjusted numbers, ratios, and rates of death for 

1999 and beyond, has important implications for assessing the relative health of racial and ethnic minorities. Compared to the ageadjusted rates using the old 1940 standard, use of the new standard 

may give the appearance that disparities in mortality have been significantly reduced. 

Age-adjusted death rates are widely used by Federal and state 

health agencies and programs to measure trends and differentials in 

the risk of death over time and among population groups and geographic areas. The rates are summary measures, or averages, across all 

age groups, which are free from the distorting effects of differences in 

age distributions among comparison groups. Age-adjusted death rates 

are indices rather than direct measures of mortality, and should be 

used only when examining trends or comparing population groups. 

Also, in detailed analyses of health, age-adjusted death rates should be 

supplemented with rates specific for age. 

Before the new policy was implemented, HHS agencies used 

several different population standards to produce age-adjusted death 

rates. This created confusion among data users, such as the media, 

and imposed a burden on State and local data users who must produce several data series in order to be consistent with Federal data. 

Use of the new standard will produce mortality data that are uniform 

throughout the Department, and that are more consistent with the 

current population structure (older) than the 1940 population standard (younger) that it replaces. In addition, it will reduce the statistical burden on State and local health agencies, and result in more 

effective communication with the public. Although researchers are 

generally required to use the new HHS standard, they may use other 

appropriate standards if a rationale is given. 

When describing the disparities in mortality that racial and ethnic minorities experience, it is important to understand the impact of 

the change in age-adjustment standard. The National Center for 

Health Statistics (NCHS) has found in preliminary analyses that the 

size of the mortality disparity between Blacks and Whites, and between Hispanics and non-Hispanics, will be affected. The changing 

population standard will also likely affect mortality differentials for 

other racial and ethnic minority groups although the effects may be 

different from that for the Black population. 

The mortality race ratio for the Black and White populations in 

1995 is reduced by a third from 1.6 using the 1940 standard to 1.4 

using the year 2000 standard. Since Blacks tend to be a younger 

population than Whites, the effect of the change from using a younger 

1940 population standard to using an older 2000 population standard will differ for Blacks than Whites. The mortality ratio is highest 

for 0 to 24 year olds, where Blacks have twice 

the death rate of Whites. For those 65 years 

of age and older, the mortality ratio is 1.1. 

Mortality race ratio based on 1940 and year 2000 The reduction in the overall (all ages combined) mortality ratio from the 1940 to the 

standard populations: U.S., 1979-1995 year 2000 standard reflects the greater weight 

that the year 2000 standard gives to the older 

population, where race differentials in mortality are smaller. The single ratio of age-ad2 justed rates masks the important age-specific 

differences in the mortality race ratio. 

Will our ability to monitor mortality trends 

be compromised? 

1.5

How does the change in the new standard affect our ability to monitor trends in 

mortality over time? While the magnitude of 

the mortality race ratio is affected by the 

1

0.5

change in standard, the trend in the ratio over 

time when the same standard is used is not 

seriously affected. The trends in the mortal­ 0

ity race ratio based on both the 1940 and 

2000 standards are nearly parallel. 

Race ratio = ratio of age-adjusted death rates for the Black popula- The widening or narrowing of the 

tion to that for the White population. continue>>>> 

Office of Minority Health Resource Center 1 U.S. Department of Health and Human Services 

19791980198119821983198419851986198719881989199019911992199319941995
Implications of New Age Adjustment Standard 

on Racial/Ethnic Health Disparities 

By Olivia Carter-Pokras, PhD


Closing the Gap, Hispanic Agenda for Action • October 1998


race gap in mortality will be approximately the same when the same 

standard is used, even if the magnitude of the gap itself is different. 

What can you do? 

OMH and NCHS recommend that you: 

• Encourage researchers analyzing mortality data by race and 

ethnicity to present their data by race/ethnicity and age (i.e., agespecific rates), not just adjusted for age. 

• Use age-specific rates when discussing racial and ethnic disparities in mortality. 

• If an age-adjusted rate or ratio has to be used to describe racial 

and ethnic disparities in mortality, make sure that users understand 

the impact of the change in the age-adjustment standard and supplement age-adjusted rates or ratios with age-specific rates. 

• When comparing age-adjusted rates or ratios over time, make 

sure the same standard is used throughout. 

• Encourage research on the impact of the new standard on 

mortality rates and ratios for Hispanic subgroups as well as American 

Indians/Alaska Natives, and Asian Americans/Pacific Islanders. 

Dr. Olivia Carter-Pokras is director of the Division of Policy and 

Data, Office of Minority Health.

Office of Minority Health Resource Center 2 U.S. Department of Health and Human Services